Robotic beyond total mesorectal excision (TME) for locally advanced or recurrent rectal cancer: a systematic review protocol

• Published in: BMJ open Vol. 14; no. 1; p. e080043
• Main Authors: Panagiotopoulou, Ioanna Georgiou, Przedlacka, Anna, Piozzi, Guglielmo Niccolò, Mills, Graham A, Harper, Mick, Khan, Jim S
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 25.01.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Protocol
• Subjects: Adult surgery; Case reports; Citation management software; Clinical trials; Colorectal cancer; Colorectal surgery; Gastrointestinal tumours; Humans; Laparoscopy - methods; Librarians; Meta-analysis; Minimally invasive surgery; Pelvis; Rectal Neoplasms - surgery; Robotic surgery; Robotic Surgical Procedures; Robotics; Statistical analysis; Subject heading schemes; Surgery; Systematic review; Systematic Reviews as Topic; Treatment Outcome; Gastrointestinal tumours; Adult surgery; Minimally invasive surgery; Colorectal surgery
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-080043

IntroductionThe surgical treatment for locally advanced or recurrent rectal cancer requires oncological clearance with a pelvic exenteration or a beyond total mesorectal excision (TME). The aim of this systematic review is to explore the safety and feasibility of robotic surgery in locally advanced and recurrent rectal cancer by evaluating perioperative outcomes, oncological clearance rates, and survival and recurrence rates postrobotic beyond TME surgery.MethodsThe systematic review will include studies published until the end of December 2023. The MEDLINE, EMBASE and Scopus databases will be searched. The screening process, study selection, data extraction, quality assessment and analysis will be performed by two independent reviewers. Discrepancies will be resolved by consensus with a third independent reviewer. The risk of bias will be assessed with validated scores. The primary outcomes will be oncological clearance, overall and disease-free survival, and local and systemic recurrence rates post robotic or robot-assisted beyond TME surgery for locally advanced or recurrent rectal cancer. Secondary outcomes will include perioperative outcomes.Ethics and disseminationNo ethical approval is required for this systematic review as no individual patient cases are studied requiring access to individual medical records. The results of the systematic review will be disseminated with conference presentations and peer-reviewed paper publications.PROSPERO registration of the studyCRD42023408098.